KELSEY DAWN MATHIS PA-C
NPI 1215491105
Physician Assistant - Medical in South Charleston, WV

NPI Status: Active since January 25, 2019

Contact Information

401 DIVISION ST STE 306
SOUTH CHARLESTON, WV
ZIP 25309
Phone: (304) 766-4300

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  • Individual
  • Female
  • Years of Experience 9
  • Physician Assistant
  • Medical
  • Accepts Insurance
  • Accepts Medicare Approved Payment
  • PECOS Enrolled

About KELSEY MATHIS

This page provides the complete NPI Profile along with additional information for Kelsey Mathis, a primary care provider established in South Charleston, West Virginia with a medical specialization in Physician Assistant, focusing in medical and more than 9 years of experience. The healthcare provider is registered in the NPI registry with number 1215491105 assigned on January 2019. The practitioner's primary taxonomy code is 363AM0700X. The provider is registered as an individual and her NPI record was last updated 7 years ago. Kelsey Mathis operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization.

NPI
1215491105
Provider Name
KELSEY DAWN MATHIS PA-C
Gender
Female
Entity Type
Individual
Location Address
401 DIVISION ST STE 306 SOUTH CHARLESTON, WV 25309
Location Phone
(304) 766-4300
Mailing Address
401 DIVISION ST STE 306 SOUTH CHARLESTON, WV 25309
Medical School Name
OTHER
Graduation Year
2018
Is Sole Proprietor?
Yes
Enumeration Date
01-25-2019
Last Update Date
01-25-2019
Code Navigator

A primary care provider (PCP) like Kelsey Mathis sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physician Assistant Medical

Taxonomy Code
363AM0700X
Type
Physician Assistants & Advanced Practice Nursing Providers
License State
WV

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Bronze 7500 $25 Generic Drugs - HMO
  • Bronze 7500 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Diabetes Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Gold 2000 $15 Generic Drugs - HMO
  • Gold 2000 $15 Generic Drugs + Adult Vision & Fitness - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Gold 3000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services - HMO
  • Healthy Heart Silver 5000 $0 Chronic Care Drugs & Services + Adult Vision & Fitness - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs - HMO
  • Low Deductible Silver 5000 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs - HMO
  • Low Premium Bronze 10600 $25 Generic Drugs + Adult Vision & Fitness - HMO
  • Low Premium Silver 6200 $3 Generic Drugs - HMO
  • Low Premium Silver 6200 $3 Generic Drugs + Adult Vision & Fitness - HMO
  • Platinum Zero $5 Generic Drugs - HMO
  • Platinum Zero $5 Generic Drugs + Adult Vision & Fitness - HMO
  • my Blue Access WV Major Events PPO Catastrophic 10600 - 3 Free PCP Visits - PPO
  • my Blue Access WV PPO Bronze 3800 - PPO
  • my Blue Access WV PPO Bronze 3800 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Bronze 9200 - PPO
  • my Blue Access WV PPO Gold 0 - PPO
  • my Blue Access WV PPO Gold 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Gold 1700 HSA - PPO
  • my Blue Access WV PPO Premier Gold 0 - PPO
  • my Blue Access WV PPO Premier Gold 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Premier Silver 0 - PPO
  • my Blue Access WV PPO Premier Silver 0 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Standard Bronze 7500 - PPO
  • my Blue Access WV PPO Standard Gold 2000 - PPO
  • my Blue Access WV PPO Standard Gold 2000 + Adult Dental and Vision - PPO
  • my Blue Access WV PPO Standard Silver 6000 - PPO

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Medicare Participation & PECOS Enrollment Status

Kelsey Mathis is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.

Kelsey Mathis is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.

What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.

  • Is the provider registered in PECOS? Yes

  • PECOS PAC ID: 2668823832

    What is the PECOS Associate Control ID?
    A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.

  • PECOS Enrollment ID: I20240111004420

    What is the Provider Enrollment ID?
    The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.

  • Accepts Medicare Assignment? Yes

    What does it mean "accepts medicare assignment"?
    When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
    A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.

  • Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes

  • Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes

  • Eligible to Order or Refer a Home Health Agency (HHA): Yes

  • Eligible to Order or Refer Power Mobility Devices: Yes

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1215491105, we treat the final digit (5) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 55. The final step is to find the difference between that total and the next multiple of ten (60 - 55 = 5).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
2
Unchanged
Pos 3
1
Doubled → 2
Pos 4
5
Unchanged
Pos 5
4
Doubled → 8
Pos 6
9
Unchanged
Pos 7
1
Doubled → 2
Pos 8
1
Unchanged
Pos 9
0
Doubled → 0
Check
5
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 4 → 8 1 → 2 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 2 + 2 + 5 + 8 + 9 + 2 + 1 + 0 + 24 = 55

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 55 is 60. The difference is the calculated check digit.

60 - 55 = 5
This NPI is valid
The calculated check digit is 5, which matches the last digit of 1215491105.

Other Providers at the Same Location


The following 6 providers are registered at the same or a nearby location.

Physician Assistant
401 DIVISION ST STE 306
SOUTH CHARLESTON, WV 25309
Obstetrics & Gynecology
401 DIVISION ST STE 306
SOUTH CHARLESTON, WV 25309
Physician Assistant (Medical)
401 DIVISION ST STE 306
SOUTH CHARLESTON, WV 25309
Nurse Practitioner (Family)
401 DIVISION ST STE 306
SOUTH CHARLESTON, WV 25309
Physician Assistant
401 DIVISION ST STE 306
SOUTH CHARLESTON, WV 25309
Obstetrics & Gynecology
401 DIVISION ST STE 306
SOUTH CHARLESTON, WV 25309

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215491105, enumerated as an "individual" on January 25, 2019.

The provider is located at 401 DIVISION ST STE 306 SOUTH CHARLESTON, WV 25309 and the phone number is (304) 766-4300.

Physician Assistant with taxonomy code 363AM0700X and a focus in Medical.

The provider might be accepting Accepts: CareSource and Highmark Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.